Preparing for your doctor’s appointment before you go will ensure that you get the most out of every visit with your psychiatrist. Here are ten practical questions to ask:
1. What is my diagnosis and how did you come to that conclusion?
This question is vital to ask when you first begin seeing your pdoc. In the 1980s, when I first got sick, there was a tendency to keep a patient’s diagnosis hush-hush, whether to protect him or because of the stigma. Either way, this did everyone a disservice. A diagnosis is a label, true, but an accurate one is the tool to managing your symptoms. How can you treat your illness if you have no idea what’s going on?
2. What medication do you propose to use? (Ask for the name and dosage level.)
Research the medication at the library, where you can refer to the Physicians’ Desk Reference, a compendium on prescription drugs, or the more user-friendly Pill Book. On the Internet, check out our Drugs page for information, interactions and side effects.
3. What is the biological effect of this medication, and what do you expect it to accomplish?
You want to know how it will change your chemistry, and the effect it will have on your body. The doctor should be able to explain this in simple terms. My psychiatrist told me that the atypical I’m on “comes at the brain in a softer way” than the traditional neuroleptics. I left it at that; however, now I’d like to press him on exactly how it balances out the chemicals.
4. What are the risks associated with the medication?
Educate yourself. Schizophrenia is a condition you’ll have to manage for the rest of your life. The drugs could have serious side effects.
Nowadays, most of the atypicals in their current formulation cause weight gain, which can lead to hypertension, diabetes and heart disease. Find out what you can do that is within your control. Talk with your doctor if you experience any side effects. Stay on your medication and work with your psychiatrist to find a solution. It may be tempting to go off your drugs; however, you’re likely to have another psychotic episode if you do. Eighty percent of the people who discontinue their meds relapse within one year.
5. How soon will we be able to tell if the medication is effective, and how will we know?
If you’ve just begun taking your pills, give them time to work. Some drugs, like antidepressants, could take four to six weeks to kick in. Switching back and forth between drugs is like “yo-yo dieting,” and doesn’t necessarily have greater benefits in the long run. My psychiatrist, who instituted a year-long cross-titer from the Stelazine to the Geodon, discontinued the old drug two weeks ago. Though my paranoia and intense worry stopped as soon as I started on the atypical, it wasn’t until recently that subtle changes continued to happen for the better.
6. Are there other medications that might be appropriate? If so, why do you prefer the one you have chosen?
Your psychiatrist should give you a reasoned, well-informed answer, not an off-the-cuff response. Ten years ago, when I had to find a doctor because the one I saw for eleven years died of a heart attack, the new doc said, “Why don’t you switch to an atypical? Everybody’s doing it.” I felt like he was using my brain as a science experiment. I didn’t trust him, so nixed this suggestion and eventually found a competent professional to treat me.
7. How do you monitor medications, and what symptoms indicate that the dosage should be raised, lowered or changed?
First of all, understand that not all drugs alleviate all symptoms at all times.
Once, at an “ask the doctor” session, the psychiatrist suggested that if someone was doing well, and the patient suddenly had breakthrough symptoms, he examined whether other forces could be at work, like increased stress or something new that happened in his patient’s life.
Only your doctor can determine whether to raise, lower or change your drug dose.
Certain symptoms, like hearing voices telling you to kill yourself or harm others, need immediate attention.
**8. Are you currently treating other patients with this illness? **
Ideally, your doctor will have experience with schizophrenia treatment, and be aware of the latest research and developments in the field.
9. What are the best times and what are the most dependable ways for getting in touch with you?
10. Do you believe someone diagnosed with schizophrenia can recover and lead a full, productive life?
If not, head out the door and find someone who does.